Evidence map›Paper›PMID 41169634›Full record

ArticleLearning health systems2025

A learning health systems approach to implementation and evaluation of an academic emergency department single shared note workflow.

Bethany M Kwan, Patrick Hosokawa, Daniel Resnick-Ault, Sean S Michael, W Gannon Sungar, Matthew Mendes, Kelly Bookman

Abstract read
In one paragraph

Article in Learning health systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bethany M KwanDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.ORCID https://orcid.org/0000-0002-4013-5618
Patrick HosokawaAdult & Child Center for Outcomes Research & Delivery Science University of Colorado School of Medicine Aurora Colorado USA.
Daniel Resnick-AultDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.
Sean S MichaelDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.
W Gannon SungarDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.ORCID https://orcid.org/0000-0002-9444-1717
Matthew MendesDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.
Kelly BookmanDepartment of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.ORCID https://orcid.org/0000-0003-2958-3249

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The application of implementation science (IS) frameworks to evaluate quality process improvement initiatives in an academic emergency department (ED) setting offers a promising approach for learning health systems (LHS). This report describes the University of Colorado Department of Emergency Medicine's LHS partnership among clinical operations, data analytics, and IS experts to evaluate a novel shared note workflow. Methods: The University of Colorado Health (UCH) ED, staffed with scribes, advanced practice providers, and physicians, implemented a shared note workflow in summer 2022. This workflow involved all parties in a clinical encounter using a single note template, unlike previous separate notes. An IS expert guided the evaluation using the implementation of change model and the theoretical domains framework, with surveys and Epic electronic health record (EHR) encounter data. Analysis included descriptive statistics and regression analysis, comparing note completion rates pre (summer 2021) and post (summer 2022 and 2023) shared notes. Results: Among 146 survey respondents, knowledge [ Conclusion: This IS-enhanced LHS evaluation of a shared note workflow in an academic ED demonstrated high satisfaction and a positive impact on note completion during shifts. Timely note completion is crucial for reducing clinician burnout and providing high-quality care. IS methods provided data-driven insights to justify the sustainment of the shared note workflow to organizational leaders.

Indexed as

emergency medicineimplementation sciencelearning health systemshared note workflow

Identifiers

PMID41169634
PMCPMC12569444

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.